冠心病患者焦虑情绪与APOE基因多态性

Association between anxiety symptom and apolipoprotein gene polymorphism in patients with coronary heart disease

目的:探讨冠心病(coronary heart disease,CHD)患者焦虑情绪与载脂蛋白E(ApoE)基因多态性的关系。方法:对符合1979年世界卫生组织CHD诊断标准的107例冠心病患者,进行汉密顿焦虑量表(Hamilton Anxiety Scale,HAMA)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)测评,依焦虑评分情况将患者分为CHD伴焦虑组(焦虑组)、CHD不伴焦虑组(无焦虑组),选择53例健康人为对照组。于入院2日内留存血样,以Hhal限制性内切酶酶切及琼脂糖凝胶电泳确定ApoE基因多态性,采用生物化学方法测定血清血脂。结果:焦虑组ε4等位基因频率高于无焦虑组和对照组(26.0%vs.10.4%,26.0%vs.13.6%;P=0.021,0.004)。焦虑组E4/4基因型频数高于无焦虑组(4vs.0,P=0.032)。焦虑组E3/4基因型频数高于对照组(17vs.8,P=0.018)。无焦虑组ε4等位基因频率高于对照组,但差异无统计学意义(13.6%vs.10.4%,P=0.802)。CHD组携带ε4等位基因患者HAMA[(13.2±5.2)vs.(9.2±6.5)]、SAS评分[(42.3±7.7)vs.(37.1±8.3)]及总胆固醇[(5.4±1.1)mmol/Lvs.(4.8±1.3)mmol/L]、低密度脂蛋白水平[(3.6±1.0)mmol/Lvs.(3.1±1.1)mmol/L]均高于非携带ε4等位基因者(P<0.05)。结论:冠心病患者的焦虑情绪可能与ApoE基因多态性具有一定关系。ApoEε4等位基因可能是CHD患者焦虑情绪的危险因素。

Objective： To investigate the genetic susceptibility and the relationship between apolipoprotein E （APOE） genetype and the anxiety symptoms in patients with coronary heart disease （CHD） . Methods： The Hamilton Anxiety Scale （ HAMA ） and Self-rating Anxiety Scale （ SAS ） were applied to assess the anxiety symptoms of 107 CHD patients. According to the HAMA or SAS score, all patients were divided into CHD with anxiety symptom group （ n = 48 ）, CHD without anxiety symptom group （ n = 59 ） . And 53 normal persons were selected as controls. The genotypes and alleles of apolipoprotein E gene were determined with polymerase reaction （ PCR ） and restriction fragment length polymorphisms （ RFLP ） technique. The total serum cholesterol, lipoprotein were detected by biochemtry methods. Results： The frequency of APOE epsilon 4 in CHD patients with anxiety was significantly higher than that in CHD patients without anxiety （ 26. 0% vs. 13.6%, P = 0. 004 ） and normal controls （26. 0% vs. 10.4%, P =0. 021） . The frequency distribution of E4/4 genetype in CHD patients with anxiety was higher than that in patients without anxiety （ 4 vs. 0, P = 0. 032 ）, and the frequency distribution of E3/4 genetype in CHD patients with anxiety was higher than that in normal controls （ 17 vs. 8, P = 0. 018 ） . The frequency of epsilon 4 was higher in CHD patients without anxiety than that in control group, but there was no remarkable difference between two groups （ 13.6% vs. 10. 4%, P =0. 802） . Compared with CHD patients without epsilon 4, the HAMAscore [ （13.2±5.2） vs. （9.2±6.5）], SASscore [ （42.3±7.7） vs. （37.1±8.3）], and the level of total cholesterol [ （ 5.4 ± 1.1 ） mmol/L vs. （4. 8 ± 1.3 ） mmol/L], low density lipoprotein [ （ 3.6 ± 1.0） mmol/L vs. [ 3. 1 ± 1. 1 ） mmol/L ] were higher in CHD patients with epsilon 4 （ all P 〈 0. 05 ） . Conclusion： The results suggest that the polymorphisms of apolipoprotein E gene is associated with the anxiety symptoms in coronary heart disease. The apolipoprotein E epsilon 4 may be a risking factor for anxiety symptom in patients with coronary heart disease.